RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, KARNATAKA. BANGALORE
COMPLETED PROFORMA FOR REGISTRATION OF SUBJECT
FOR DISSERTATION
A CLINICAL STUDY ON THE EFFECT OF DARVYADI KVATHA IN THE MANAGEMENT OF ASRIGDARA.
BY
Dr. SHEETAL
M.S. (AYU) SCHOLAR
DEPT OF P.G STUDIES IN PRASOOTI TANTRA AND STREE ROGA
S.D.M.COLLEGE OF AYURVEDA
HASSAN - 573201
GUIDE :
Dr. VISHWESH B.N.
M.S (Ayu) Ph.D, I.M.S.(BHU)
ASSOCIATE PROFESSOR
DEPT OF P.G.STUDIES IN PRASOOTI TANTRA AND STREE ROGA
S.D.M.COLLEGE OF AYURVEDA
HASSAN-573201
S.D.M. COLLEGE OF AYURVEDA AND HOSPITAL B.M. ROAD, THANNIRUHALLA,
HASSAN-573201
2012-2013
From,
Dr. SHEETAL
Department of Post Graduate Studies in Prasooti Tantra & Stree Roga
S.D.M. College of Ayurveda and Hospital,
Hassan- 573201.
To,
The Registrar,
Rajiv Gandhi University of Health Sciences
Bangalore, Karnataka.
Through,
The Principal and Head of Department of PG studies in Prasooti Tantra & Stree Roga S.D.M. College of Ayurveda & Hospital, Hassan-573201
Subject: Submission of Completed Performa for Registration of Synopsis of Dissertation.
Respected Sir,
I request you to kindly register the below mentioned subject against my name for the submission of the dissertation to the Rajiv Gandhi University of Health Sciences, Bangalore, for partial fulfillment of M.S. (Ayurveda) in in Prasooti Tantra & Stree Roga.
THE TITLE OF DISSERTATION:
" A CLINICAL STUDY ON THE EFFECT OF DARVAYADI KVATHA IN THE MANAGEMENT OF ASRIGDARA"
Herewith I am enclosing completed Performa for Registration of Subject of dissertation.
Thanking you,
Date: Yours faithfully
Place
(Dr. SHEETAL)
KARNATAKA, BANGALORE.
ANNEXURE – II
COMPLETED PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION.
1. Name of the Candidate &
ADDRESS : DR SHEETAL
PRELIMINARY M.S (AYU)
Dept. OF PRASUTI TANTRA EVAM STREE ROGA
S.D.M. College of Ayurveda &
Hospital, HASSAN 573201
PERMANENT ADDRES : D/O YASH PAL SHARMA
VPO BADYAL BRAHMANA,
TEH. R. S. PURA,
DISTT JAMMU, 181103
2. Name of the INSTITUTION : S.D.M COLLEGE OF AYURVEDA &
HOSPITAL, HASSAN – 573201
3. Course of Study
& Subject : M.S. (Ayu)
prasooti TANTRA EVAM
STREE ROGA
4. Date of Admission to
the course : 20/7/2012
5. TITLE OF THE TOPIC : " A CLINICAL STUDY ON THE EFFECT
OF DARVAYADI KVATHA IN THE
MANAGEMENT OF ASRIGDARA"
6. BRIEF RESUME OF THE STUDY
6.1 NEED FOR THE STUDY:
The process of cyclic menstruation is a natural phenomenon. Regular cyclic menstruation results from the relationship between the endometrium and its regulating factors. Menstruation denotes the healthy state of female reproductive system but if the cycle turns to be abnormal with excessive and prolonged bleeding, associated with pain or during the intermenstrual period, it is suggestive of some underlying pathology.
Dysfuntional Uterine Bleeding is best defined as abnormal uterine bleeding without any clinically detectable organic pelvic pathology i.e. tumors, inflammation or pregnancy.1 It is characterized by excessive, prolonged menstrual or inter-menstrual bleeding. Prevalance rate in the population varies from 4 to 27%.2 It is majorly seen in adolescent, peri-menopausal, and reproductive age group. About 10-30% of reproductive aged women suffer from this disorder . In 80 to 90% of them bleeding results from dysfuntion of HPO axis (hypothalmic - pitutary -ovarian axis), which leads to anovulation.3
The word Asrigdara means prolonged or excessive menstrual bleeding. Due to excessive excretion of Raja it is named as Pradara and since there is excessive excretion of Asrk it is known as Asrigdara. It is caused due to excessive intake of lavana , amla , guru , katu , vidahi ahara , snigdha dravyas , gramya , odaka mamsa , krishara , payas , dadhi , shukta , mastu , sura etc. and cause many complications in the woman like Daurbalya, Brama, Pandu, Murcha, Trishna, Daha, Tama, Tandra , etc.4
Ayurveda describes a wide range of treatment options in the management of Asrigdara. In this study, Darvayadi kvatha (a combination of indigenous drugs consisting of Daruharidra , Rasanjan , Musta , Bhallattaka , Shriphala , Vrsha and Kiratiktha5 ) mentioned in the context of Asrgdhara is taken, considering their karmas like stambhan, garbhashayankochaka, balya and raktshodhaka. The effect of this formulation on Asrigdara will be studied here.
6.2 REVIEW OF LITERATURE
Some of the diseases in Striroga present with lakshanas of prolonged , excessive menstrual bleeding. Important among them is Asrigdara.6,7,8,9,10 Excessive or prolonged blood loss during menstruation with or without bleeding during the inter-menstrual bleeding is called as Arigdara.11
In the context of raktyoni , asrij and rudikshara yonivyapats also prolonged excessive menstrual bleeding is found as a symptom.7,8.In pittaja and raktaja artavadushti also presents with prolonged, excessive menstrual bleeding.10
It can be co-related with DUB i.e. Dysfuntional Uterine Bleeding which can be defined as(excessively heavy, prolonged or frequent) of uterine origin which is not due to any demonstrable pelvic disease, complications of pregnancy or systemic disease.12
.Darvayadi Kvatha has been mentioned by various classics as a formulation to treat pradra.5,13,14.It contains Daruharidra , Rasanjan Musta , Bhallattaka , Shriphala , Vrsha and Kiratiktha.5 These drugs are are said to be stambhak, and garbhashayasankochaka.
PREVIOUS WORK DONE
· Vinutha c – Role of certain indigenous drugs & uttarabasti in pradara w.s.r to Dysfunctional uterine bleeding.. RGUHS of Banaglore. S.D.M College of Ayurveda. Udupi. (2003).
· Bhadane Vaishali - Use of Vasa Swaras in Rakta pradara.. Tilak, Pune university, Ayurveda Mahavidyalaya. Pune. (2004) .
· Narkhedi Deepali v – Comparative study on the effect of Kashmarya – Kutaja Ghrita uttarabasti & Pushyanuga choorna in Asrigdara, Kerala university, . Government Ayurvedic college .Thiruvananthapuram.(2004).
· Khairnar premraj p – Study of efficacy of Darvyadi kwath in comparison with Kutaja Tvaka in the treatment of Raktapradara, Pune university. Tilak Ayurveda Mahavidyalaya pune .( 2005).
· Dr. M .Supriya : Role of Piccha Basti in Athyartava. RUGHS Of Bangalore, S.D.M.College of Ayurveda. Udupi.( 2009).
· Jyoti - A study on the effect of management of Pradaranga Ras in Asrigdara . Government Medical College . Trivandrum,Kerela University .2002
· Srivastava Java - Effect of Bhumyamalaki in Asrigdhara .Banaras Hindu University.2005
· 6.3 OBJECTIVES OF THE STUDY:
To evaluate the effect of Darvayadi kvatha in the management of Asrigdara.
7. MATERIALS AND METHODS:
7.1 SOURCE OF DATA:
OPD and IPD , Departmentt of of Prasuti Tantra & Stree Roga, Shri Dharamsthala Manjunatheshwara College of Ayurveda and Hospital , Hassan.
Source of drug:
Darvyadi kvatha, prepared according to classics will be packed and made available from the SDM pharmacy, Hassan.
Drug review :
S.N. / SANSKRIT NAME / BOTANICAL NAME / PART USED / PROPORTION1 / Daruharidra / Berberis aristata / Kashta / E Q
2 / Rasanjan / Berbris aristata / Darvi extract / EQ
3 / Musta / Cyperus rotundus / Tubers / EQ
4 / Bhallataka / Semicarpus anacardium / Seeds / EQ
5 / Shriphala / Aegle marmelos / Phalamajja / EQ
6 / Vrisha / Adhathoda vesica / Patra / EQ
7 / Kiratiktha / Swertia chirayita / Whole plant / EQ
7.2 METHOD OF COLLECTION OF DATA:
A .PLAN OF STUDY:
It is a single blind clinical study. A minimum of 30 patients, fulfilling the inclusive criteria and exclusive criteria will be selected. A detailed performa will be prepared considering all points of history taking, physical examination, lab investigation. The parameters of signs & symptoms, before treatment & after treatment will be scored and analyzed on the basis of standard method of statistical analysis.
B. DIAGNOSTIC CRITERIA
Diagnosis will be made on the basis of symptoms of Arigdara
· Heavy menstrual bleeding
· Prolonged menstruation
· Inter menstrual bleeding.
C. INCLUSION CRITERIA:-
· Patients presenting with prolonged, excessive menstrual bleeding, inter-menstrual bleeding.
· Patients between the age group of 16-40 years.
· Patients diagnosed as DUB.
· Patients ready to sign the informed consent form .
D. EXCLUSION CRITERIA:-
· Patients with chronic illness
· Patients using intrauterine contraceptive device.
· Patients with uterine and Pelvic pathology.(fibroid, adenomyosis)
· Benign and malignant growth.
· Endometrial and endocervical polyp.
· Thyroid dysfuntion
· Threatened , spontaneous or incomplete abortion / Ectopic pregnancy
LABORATORY EXAMINATIONS :
Following investigations will be carried out for proper diagnoses and to rule out major pelvic pathology.
· CBC
· UPT
· USG Pelvis
· Thyroid Profile
DOSE:-
50 ml of kvatha in 2 divided doses before meals for 3 months
Anupana -Madhu
ASSESSMENT CRITERIA:-
Ø Amount of bleeding
Ø Duration of flow
Ø Regularity of cycle
FINAL ASSESSMENT:
Cured : Cyclic normal menstrual bleeding
Improved : Reduction in the duration & amount of bleeding per vaginum.
No change : No notable change in pattern of bleeding.
Aggravated : Condition worsened.
FOLLOW-UP STUDY:
Patients will be asked to review after 15 days and same will be continued for 3 months. The improvement will be assessed by score card method.
7.3 Does the study involve any investigation or intervention to be done on patients or other human or animal?
The study will be a human clinical study, no animal experimentation will be conducted.
7.4 HAS ETHICAL CLEARENCE BEEN OBTAINED FROM YOUR INSTITUTION:- Yes.
8. LIST 0F REFERENCES :-
1. Dutta DC. Text book of Gynaecology including contraception.4th ed. Calcutta: New Central Book Agency;2007.p.177.
2.GP. Abnormal uterine bleeding. http://www.gponline.com/Clinical/article/914633/Abnormal-uterine-bleeding (accessed 20-03-2013).
3.Schorge OJ , Scaffer J ,Halvorsan ML.[et.al]. Williams Gynecology. Texas :Parkland Health and Hospital System;p.186.
4. Tiwari PV(eds.). Ayurvediya Prasuti Tantra Evam Striroga. 2nd ed.Varanasi: Chaukhambha Orientalia;2007.p.172-95.
5. Murthy HC (eds.) Sarangadhara samhita [English Translation].1st ed. Varanasi Chaukhamba Sanskrit sansthan; 2007.p.130.
6. Trikamji J. Charak Samhita by Agnivesha Revised by Charak &Dridhabala with the Ayurveda Dipika commentary of Chakrapanidatta. Varanasi: Chaukhambha Sanskrit Sansthan; 2004.P.768.
7. Trikamji J , Ram N. Susruta Samhita of Susruta of Sri Dalhanacharya. Varanasi: Chaukhamba Sanskrit Sansthan; 2010.P.669.
8. Kingwadekar RS .Astanga Sangraha of Vagbhttviechit, Sharirsthan. 2nd .ed. Delhi: Sri Satguru Publications;1990.P.4.
9. Tripathi B. Astanga Hrdayam of Srimadvagbhata. Delhi: Choukamba Sanskrit Pratisthan; 2009. P.1132.
10.Vd Lalchandra . Ashtang Hrdayam Sarvangasundary vyakhya vibhush, Motilal Banarasidas.Delhi,Mumbai,Channai,Bangaiore,Varanasi,Pune,Patna.Reprint:Delhi 1977,1990,1999.p.221.
11. Usha VNK. Stree Roga Vignan Text book of Gynecology. Ist ed. Varanasi:Chaukhamba Sanskrit Pratishthan;2010.p.130.
12. Presannakumari B. Postgraduate Gynecology.Ist ed.Jaypee Brothers Medical Publishers;2011.p.98.
13.Mishra BS [ed].The Kashi Sanskrit series Bhav Prakash of Shri Bhav Prakash Mishra edited with Vidyotini Hindi Commentary .Varanasi: Chaukhambha Sanskrit Sansthan ;.2003.762.
14. Shastri BB. The kashi Sanskrit Series of Yogratnakar Vidyotini Hindi Commentary by Vaidya Lakshmipati Shastri. 7th ed. Varanasi: Chaukhambha Sanskrit Sansthan; 1999.p.398.
9) Signature of the candidate :
10) Remark of the Guide :
11) Name and designation :
of Guide (in Block letters) : DR. VISHWESH B.N. M.S (Ayu) Ph.D, I.M.S.(BHU)
ASSOCIATE PROFESSOR.
DEPT OF P. G. STUDIES IN
PRASOOTI TANTRA & STREEROGA
. S. D. M. COLLEGE OF AYURVEDA.
HASSAN-573201
11.1) Signature :
11.2) Head of the Department : DR. GAYATHRI BHAT N.V. M.S. (Ayu)
ASSOCIATE PROFESSOR
DEPT OF P. G. STUDIES IN
PRASOOTI TANTRA & STREEROGA
S. D. M. COLLEGE OF AYURVEDA.
HASSAN -573201
11.3) Signature :
12) Remarks of the chairman
& the Principal :
12.1) Principal : DR. PRASSANA N. RAO M.S (Ayu), I.M.S. BHU Ph.D,
S. D. M. COLLEGE OF AYURVEDA.
HASSAN -573201 .
12.2) Signature :